通讯作者: 杨一君, nowdreamadream@126.com

DOI：10.12201/bmr.202606.00064

Clinical Observation and Therapeutic Efficacy Evaluation of Botulinum Toxin Type A Injection in the Treatment of Abducens Nerve Palsy-Induced Esotropia

• 摘要：目的：探讨A型肉毒毒素（BTX-A）注射治疗对早期外展神经麻痹性内斜视的临床疗效与安全性。方法：回顾性分析 2023年8月至2025年2月期间于南京医科大学附属淮安第一医院眼科就诊接受A型肉毒毒素治疗的52位外展神经麻痹性内斜视患者的临床资料。所有患者均随访6个月，采用非参数检验，比较患者治疗前后不同时间点（注射前、注射后1、3、6个月）的斜视度、眼位正位率、眼球运动等临床指标，对治疗效果进行量化评估。结果：与注射前相比，所有患者在注射后1、3、6个月的斜视度均显著减小（P<0.001），正位率显著提高（P<0.001），眼球运动受限情况得到显著改善（P<0.001）。斜视度中位数从注射前的35.0△显著降低至注射后1个月的10.0△、3个月的10.0△和6个月的7.5△。注射后3个月与6个月的斜视度相比，差异无统计学意义（P>0.05），提示疗效趋于稳定。治疗6个月后，总有效率达80.77%。相关性分析显示，眼球运动功能的改善与正位率的提升显著相关（P<0.05）。多元回归分析表明，初始斜视度和眼球运动功能的改善是影响斜视度改善幅度的独立预测因子（P<0.05）。对治疗无效患者的分析发现，其初始斜视度显著高于有效患者（P<0.001）。结论：A型肉毒毒素能安全、有效地改善早期外展神经麻痹性内斜视患者的眼位和眼球运动功能，疗效在3个月后趋于稳定。初始斜视度较大的患者可能预后较差。该方法为临床治疗外展神经麻痹性内斜视提供了可靠的非手术选择。

  关键词： 外展神经麻痹性内斜视; A型肉毒毒素; 治疗; 临床指标

   

  Abstract: AbstractObjective: To investigate the clinical efficacy and safety of botulinum toxin type A (BTX-A) injection for the treatment of early-stage esotropia secondary to abducens nerve palsy. Methods: This retrospective study analyzed the clinical data of 52 patients (52 eyes) with abducens nerve palsy-induced esotropia who received BTX-A treatment at the Department of Ophthalmology, Huai''an First Hospital Affiliated to Nanjing Medical University, from August 2023 to February 2025. All patients were followed up for 6 months. Non-parametric statistical tests were used to compare clinical parameters—including the degree of strabismus, orthophoria rate, and grade of ocular motility restriction—at different time points (pre-injection, and 1, 3, and 6 months post-injection). Therapeutic efficacy and its influencing factors were also evaluated. Results: Compared to pre-injection levels, the degree of strabismus was significantly reduced, while the orthophoria rate and ocular motility were significantly improved at 1, 3, and 6 months post-injection (all P<0.001). The median strabismus deviation decreased from 35.0△ pre-injection to 10.0△ at 1 month, 10.0△ at 3 months, and 7.5△ at 6 months. There was no statistically significant difference in deviation between 3 and 6 months post-injection (P>0.05), suggesting that the therapeutic effect stabilized. At the 6-month follow-up, the overall effective rate was 80.77%. Correlation analysis revealed a significant association between the improvement in ocular motility and the achievement of orthophoria (P<0.05). Furthermore, multiple regression analysis identified baseline strabismus deviation and improvement in ocular motility as independent predictors of the magnitude of strabismus correction (P<0.05). An analysis of non-responders showed that their baseline strabismus deviation was significantly greater than that of responders (P<0.001). Conclusion: BTX-A injection is a safe and effective non-surgical option for improving ocular alignment and motility in patients with early-stage abducens nerve palsy-induced esotropia. The therapeutic effect tends to stabilize after 3 months. Patients with a larger initial angle of deviation may have a poorer prognosis.

  Key words: Abducens Nerve Palsy-Induced Paralytic Esotropia; Botulinum Toxin Type A (BTX-A); Treatment; Clinical Parameters

  提交时间：2026-06-20

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• 序号	提交日期	编号	操作
  1	2026-04-25	10.12201/bmr.202606.00064V1	下载

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